Background: The management of thoraco lumbar and lumbar injuries depends on the mechanical and neurological problems due to injury of bone, ligaments, disc and cord. The steffee system of transpedicular spinal stabilization, when used with correct operative technique and a sound knowledge of the morphology of pedicles at various levels is a good, cost effective implant which can be adapted for usage in all types of thoracolumbar injuries with minimal complications. Materials and Methods: In a prospective study conducted in the Postgraduate Department of Orthopaedics, Pudukkottai Government Medical College and Hospital, Tamilnadu over a period of 2 years. Fifty cases, both male and female in the age group of 20 to 60 years, who had undergone steffee fixation for various types of spinal injuries with neurological deficit were included. The results were analyzed according to neurological improvement as per Frankel's grading, the complications and the duration of hospital stay in both the groups. Results: In this series 80% of patients had spinal injuries at the thoraco lumbar [D12 -L1] level. Burst Fractures and fracture dislocation were the two most common types of fractures and accounted for about 90% of the spinal injuries in this study. Out of 50 cases, 44 patients the results were good. Of the remaining 6 patients screw breakage occurred in 2 patients after the injured vertebrae had fused. Implant backing out was seen in two patients, but the K angle was maintained and the injured vertebrae had fused. Only in one patient the result was poor as there was screw breakage in the first month which led to loss of spinal stabilization. Conclusion:The steffee system of transpedicular spinal stabilization, when used with correct operative technique and a sound knowledge of the morphology of pedicles at various levels is a good, cost effective implant which can be adapted for usage in all types of thoracolumbar injuries with minimal complications.
Background:The aim of the study is to evaluate the functional outcome of displaced fractures of the proximal humerus managed surgically. Methods: A prospective analysis of the functional outcome of 20 cases under surgically managed displaced proximal humeral fractures were undertaken in our hospital. The indications of the surgery were displacement to more than 1 cm and angulation of more than 45°. The patients were operated by the standard anterior deltopectoral approach, deltoid splitting or percutaneous procedure depending upon the type of fracture and bone quality. Results: The mean age of the patients was 44 years. The mode of injury was fall at ground level in 10(50%) patients, road traffic accident in 6(30%) patients, fall from height in 3(15%) patients, fall due to epilepsy in 1(5%) patients. Based on Neer's sytem 10 patients (50%) had two part fractures, 5(25%) patients had 3 part fractures and 5(25%) had four part fractures. Greater Tuberosity fractures were the predominant type in 2 part fracture. Patients underwent the surgery on an average of 7.95 days after injury. The mean follow-up period in this study was 12.2 months. Conclusion: Displaced proximal humeral fractures when treated surgically produce less pain, less stiffness and greater range of motion. Earlier the surgery better are the results. Results are better with fractures than with fracture dislocations. Results are best when operative method results in stable fixation that allows early passive mobilization. Functional outcome of 2 part fractures is better than 3 part and 4 part fractures.
Background :This study is to investigate the effects of immediate post operative orthopaedic Rehabilitationon lower limb. Orthopaedic internal fixations like proximal femoral nailing femur, Intramedullary nailingtibia to reduce fear avoidance belief and early ambulation. Which reduces the long stay duration in hospitaland prevent post operative stiffness, other complications. This early mobilization improvesresolution ofhealing of wounds and pain. When compare to conventional methods of physiotherapy.Materials and Methods: 45 subjects selected randomly and subdivided into 3 groups experiment. I=IPOR,n=15 Experiment II =conventional group, control group, n=15 subjects selected from inpatients postoperative orthopaedic wards both female and males selected subjects are n=15 in each group being to agegroup (30-56) both male and female patients with fractures femur and tibia respectively primary outcomemeasures assessed by 3 different assessment questionnaire fear avoidance belief questionnaire and visualanalogue pain scale for those who undergone physiotherapy for 10 days.Results :3 groups of 10 days under supervision by physiotherapist inpatient orthopaedic wards and pretherapyFABQ ( Fear avoidance belief questionnaire) and visual analogue scale pain scale questionnaire and posttherapy after 10 days given among 3 groups experimental group 1. IPOR shows significant improvementin fear avoidance belief and early ambulation. So this early mobilization reduces pain stiffness and reducesthe hospital stay. When compare to other 2 groups ‘P’ value shows difference, SD=+5 Anacova methodstatistical analysis done.Conclusion :Immediate post operative orthopaedic rehabilitation which is more beneficial and effectivein reducing, overcoming fear avoidance behaviour and enhances early ambulation which is more beneficialand enhances early ambulation which makes. Quick recovery in post operative orthopaedic surgeries whencompare to other methods
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